Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion

Adrian Au; Assaf Hilely; Jackson Scharf; Frederic Gunnemann; Derrick Wang; Ismael Chehaibou; Claudio Iovino; Christelle Grondin; Marie Louise Farecki; Khalil Ghasemi Falavarjani; Nopasak Phasukkijwatana; Marco Battista; Enrico Borrelli; Riccardo Sacconi; Brittany Powell; Grant Hom; Tyler E. Greenlee; Thais F. Conti; Gerardo Ledesma-Gil; Mehmet Yasin Teke; Netan Choudhry; Adrian T. Fung; Valerie Krivosic; Jiwon Baek; Mee Yon Lee; Yoshimi Sugiura; Giuseppe Querques; Enrico Peiretti; Richard Rosen; Won Ki Lee; Lawrence A. Yannuzzi; Dinah Zur; Anat Loewenstein; Daniel Pauleikhoff; Rishi Singh; Yasha Modi; Jean Pierre Hubschman; Michael Ip; Srini Vas Sadda; K. Bailey Freund; David Sarraf

doi:10.1167/IOVS.61.5.54

Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion

Adrian Au, Assaf Hilely, Jackson Scharf, Frederic Gunnemann, Derrick Wang, Ismael Chehaibou, Claudio Iovino, Christelle Grondin, Marie Louise Farecki, Khalil Ghasemi Falavarjani, Nopasak Phasukkijwatana, Marco Battista, Enrico Borrelli, Riccardo Sacconi, Brittany Powell, Grant Hom, Tyler E. Greenlee, Thais F. Conti, Gerardo Ledesma-Gil, Mehmet Yasin TekeNetan Choudhry, Adrian T. Fung, Valerie Krivosic, Jiwon Baek, Mee Yon Lee, Yoshimi Sugiura, Giuseppe Querques, Enrico Peiretti, Richard Rosen, Won Ki Lee, Lawrence A. Yannuzzi, Dinah Zur, Anat Loewenstein, Daniel Pauleikhoff, Rishi Singh, Yasha Modi, Jean Pierre Hubschman, Michael Ip, Srini Vas Sadda, K. Bailey Freund, David Sarraf

Research output: Contribution to journal › Article › peer-review

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Abstract

PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.

Original language	English
Article number	54
Journal	Investigative Ophthalmology and Visual Science
Volume	61
Issue number	5
DOIs	https://doi.org/10.1167/IOVS.61.5.54
State	Published - May 2020
Externally published	Yes

Keywords

Central retinal vein occlusion
Ischemia
Neovascularization
Nerve fiber layer hemorrhages

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10.1167/IOVS.61.5.54

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Au, A., Hilely, A., Scharf, J., Gunnemann, F., Wang, D., Chehaibou, I., Iovino, C., Grondin, C., Farecki, M. L., Falavarjani, K. G., Phasukkijwatana, N., Battista, M., Borrelli, E., Sacconi, R., Powell, B., Hom, G., Greenlee, T. E., Conti, T. F., Ledesma-Gil, G., ... Sarraf, D. (2020). Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion. Investigative Ophthalmology and Visual Science, 61(5), Article 54. https://doi.org/10.1167/IOVS.61.5.54

@article{94cf68c365924cd5b5c67786a03f7738,

title = "Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion",

abstract = "PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.",

keywords = "Central retinal vein occlusion, Ischemia, Neovascularization, Nerve fiber layer hemorrhages",

author = "Adrian Au and Assaf Hilely and Jackson Scharf and Frederic Gunnemann and Derrick Wang and Ismael Chehaibou and Claudio Iovino and Christelle Grondin and Farecki, {Marie Louise} and Falavarjani, {Khalil Ghasemi} and Nopasak Phasukkijwatana and Marco Battista and Enrico Borrelli and Riccardo Sacconi and Brittany Powell and Grant Hom and Greenlee, {Tyler E.} and Conti, {Thais F.} and Gerardo Ledesma-Gil and Teke, {Mehmet Yasin} and Netan Choudhry and Fung, {Adrian T.} and Valerie Krivosic and Jiwon Baek and Lee, {Mee Yon} and Yoshimi Sugiura and Giuseppe Querques and Enrico Peiretti and Richard Rosen and Lee, {Won Ki} and Yannuzzi, {Lawrence A.} and Dinah Zur and Anat Loewenstein and Daniel Pauleikhoff and Rishi Singh and Yasha Modi and Hubschman, {Jean Pierre} and Michael Ip and Sadda, {Srini Vas} and Freund, {K. Bailey} and David Sarraf",

year = "2020",

month = may,

doi = "10.1167/IOVS.61.5.54",

language = "English",

volume = "61",

journal = "Investigative Ophthalmology and Visual Science",

issn = "0146-0404",

publisher = "Association for Research in Vision and Ophthalmology Inc.",

number = "5",

}

Au, A, Hilely, A, Scharf, J, Gunnemann, F, Wang, D, Chehaibou, I, Iovino, C, Grondin, C, Farecki, ML, Falavarjani, KG, Phasukkijwatana, N, Battista, M, Borrelli, E, Sacconi, R, Powell, B, Hom, G, Greenlee, TE, Conti, TF, Ledesma-Gil, G, Teke, MY, Choudhry, N, Fung, AT, Krivosic, V, Baek, J, Lee, MY, Sugiura, Y, Querques, G, Peiretti, E, Rosen, R, Lee, WK, Yannuzzi, LA, Zur, D, Loewenstein, A, Pauleikhoff, D, Singh, R, Modi, Y, Hubschman, JP, Ip, M, Sadda, SV, Freund, KB & Sarraf, D 2020, 'Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion', Investigative Ophthalmology and Visual Science, vol. 61, no. 5, 54. https://doi.org/10.1167/IOVS.61.5.54

TY - JOUR

T1 - Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion

AU - Au, Adrian

AU - Hilely, Assaf

AU - Scharf, Jackson

AU - Gunnemann, Frederic

AU - Wang, Derrick

AU - Chehaibou, Ismael

AU - Iovino, Claudio

AU - Grondin, Christelle

AU - Farecki, Marie Louise

AU - Falavarjani, Khalil Ghasemi

AU - Phasukkijwatana, Nopasak

AU - Battista, Marco

AU - Borrelli, Enrico

AU - Sacconi, Riccardo

AU - Powell, Brittany

AU - Hom, Grant

AU - Greenlee, Tyler E.

AU - Conti, Thais F.

AU - Ledesma-Gil, Gerardo

AU - Teke, Mehmet Yasin

AU - Choudhry, Netan

AU - Fung, Adrian T.

AU - Krivosic, Valerie

AU - Baek, Jiwon

AU - Lee, Mee Yon

AU - Sugiura, Yoshimi

AU - Querques, Giuseppe

AU - Peiretti, Enrico

AU - Rosen, Richard

AU - Lee, Won Ki

AU - Yannuzzi, Lawrence A.

AU - Zur, Dinah

AU - Loewenstein, Anat

AU - Pauleikhoff, Daniel

AU - Singh, Rishi

AU - Modi, Yasha

AU - Hubschman, Jean Pierre

AU - Ip, Michael

AU - Sadda, Srini Vas

AU - Freund, K. Bailey

AU - Sarraf, David

PY - 2020/5

Y1 - 2020/5

N2 - PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.

AB - PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 μm) compared to the group with deep hemorrhages alone (455 ± 273 μm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). CONCLUSIONS. NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.

KW - Central retinal vein occlusion

KW - Ischemia

KW - Neovascularization

KW - Nerve fiber layer hemorrhages

UR - http://www.scopus.com/inward/record.url?scp=85085539603&partnerID=8YFLogxK

U2 - 10.1167/IOVS.61.5.54

DO - 10.1167/IOVS.61.5.54

M3 - Article

C2 - 32460316

AN - SCOPUS:85085539603

SN - 0146-0404

VL - 61

JO - Investigative Ophthalmology and Visual Science

JF - Investigative Ophthalmology and Visual Science

IS - 5

M1 - 54

ER -

Relationship between nerve fiber layer hemorrhages and outcomes in central retinal vein occlusion

Abstract

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